ABSTRACT
Objective: To report the prevalence, clinical differences and complications of right-sided diverticulosis [RD] and to investigate the potential disparities from left-sided diverticulosis [LD] in the Vietnamese population
Subjects and Methods: A retrospective cohort study was conducted using medical records of Vietnamese-born patients from 2000 to 2013 in a community teaching hospital in Boston, Mass., USA. By simple randomization, a randomized control group of 299 Caucasian patients was also selected from the same time frame [167 males [M] and 132 females [F]]. Colonoscopy reports were reviewed for demographics [age and gender], indication and anatomical location of the colonic diverticulosis [CD], concomitant colonic findings, symptoms, and endoscopic complications
Results: A total of 207 patients were included in the Vietnamese cohort [mean age 61.6 +/- 8.9 years]. The mean age at first screening colonoscopy was 58.2 +/- 7.2 years [114 F/92 M, 55.7/44.4%]. Our study identified 104 [50.5%] patients with LD [57 M/47 F], 65 [31.1%] with RD [35 M/30 F] and 38 [18.4%] with both LD and RD [23 M/15 F]; 133 [64%] were asymptomatic. A total of 21 [33%] patients with RD were symptomatic. The mean age of the control group was 61.6 +/- 8.1 years. The average age at first screening colonoscopy was 52.8 +/- 6.4 years. Of the 299 in the Caucasian group, 254 [84.9%] had LD [114 M/140 F], 9 [3.0%] had RD [2 M/7 F] and 36 [12%] had both LD and RD [16 M/20 F]; 225 [75%] were asymptomatic and came in for screening colonoscopies. A total of 2 patients [22%] with RD were symptomatic
Conclusion: RD was common in this Vietnamese population, and the prevalence was higher than in the Caucasian control group
Subject(s)
Humans , Male , Female , Aged , Diverticulosis, Colonic , Health Status Disparities , Retrospective Studies , Cohort Studies , Asian People , PrevalenceABSTRACT
Interatrial block [IAB] denotes a conduction delay between the two atria [P-wave duration >/=110 ms]. Depending on the severity of the block, IAB can be partial or advanced. Even though several studies have reported a high prevalence of IAB, it still remains a diagnosis many neglect without any follow-up. The crisis in IAB is undramatic until predictable complications appear. Nevertheless, the danger in IAB is real because of the major associations with multiple medical conditions, including atrial fibrillation, myocardial ischemia, left atrial enlargement, and systemic emboli. There are different treatment options for IAB to eliminate its consequences, including pacing and medical management with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Pacing has been shown to give promising results and could potentially prevent conditions related to cardiovascular disease such as hypertension or diabetes mellitus. Given the high prevalence of IAB, together with its potentially serious consequences, and yet being largely ignored, we stress attention to this potentially dangerous pandemic and raise consideration for further investigations
ABSTRACT
To report a case of spontaneous tumor lysis syndrome [STLS] of a solid tumor in a patient who had undiag-nosed metastatic hepatocellular carcinoma. A 70-year-old man with a medical history of alcohol abuse, withdrawal seizure and hypertension presented to the emergency department after being found unresponsive by his landlord. The patient had a bulky mass in the liver, classic laboratory abnormalities, oliguric renal failure and elevated alpha fetoprotein. He had never been treated with cytotoxic therapy. He was treated aggressively with fluid resuscitation and sodium bicarbonate, but he continued to be oliguric and the deterioration of his renal function also continued. Due to a minimal response to treatment and a poor prognosis, he was discharged to hospice for palliative care. This case showed that STLS should be in the differential diagnosis of a patient who has malignant disease and has developed classic laboratory abnormalities and renal failure even without previous cytotoxic therapy